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Am J Dis Child. 1927;34(2):180-186. doi:10.1001/archpedi.1927.04130200024004.
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At the present time, there is considerable divergence of opinion as to whether infants with congenital hypertrophic pyloric stenosis should be treated medically or surgically. Certain authors believe that all infants should be treated medically; others, that medical treatment should first be tried and that if it is unsuccessful, surgical methods should be employed; while on the other hand, some observers believe that all infants should be submitted to operation as soon as the diagnosis has been made.

DIAGNOSIS  Before this question can be discussed intelligently, the diagnosis must be considered briefly. The cardinal symptoms and signs are; (1) projectile vomiting; (2) visible gastric peristalsis; (3) palpable pyloric tumor, and (4) constipation with a small amount of material in the stool. The patients usually present a fulness in the upper part of the abdomen as contrasted with the portion below the umbilicus. If the constriction of the pylorus is marked


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